Pericardial effusion causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.

Overview

Pericardial effusion can be classified into serous, bloody and chylous based on the composition of the effusion fluid. Infections and inflammation usually cause serous effusion while bloody effusions are as a result of trauma to the heart. Though iatrogenic causes and infections are common etiologies, pericardial disease may also be a feature of other disorders such as inflammatory bowel disease. Aortic dissection or free wall rupture should also be considered in patients with unstable hemodynamics and pericardial effusion.

Causes

Life Threatening Causes

• Acute myocardial infarction
• Aortic dissection
• Aortic rupture
• Myocardial rupture
• Scorpion sting
• Uremic pericarditis
• Ventricular aneurysm

Common Causes

• Acute myocardial infarction
• Aortic dissection
• Aortic rupture
• Bacterial pericarditis
• Cardiac catheterization
• Cardiomyopathy
• Chemotherapy
• Chest trauma
• Collagen vascular disease
• Congestive heart failure
• Dressler's syndrome
• Neoplasm
• Postpericardiotomy syndrome
• Postirradiation
• Rheumatic pericarditis
• Tuberculous pericarditis
• Uremic pericarditis
• Viral pericarditis

Causes by Organ System

Cardiovascular	Acute myocardial infarction, aortic dissection, aortic rupture, bacterial pericarditis, benign obstruction of thoracic duct, Cantu syndrome, capillary leak syndrome, cardiomyopathy, congestive heart failure, constrictive pericarditis, dilated cardiomyopathy, dissecting aortic aneurysm, Dressler's syndrome, hypersensitivity pericarditis with eosinophilia, hypertrichotic osteochondrodysplasia, Kawasaki disease, myocardial rupture, pericarditis, heart surgery, fungal pericarditis, pyogenic pericarditis, rheumatic pericarditis, tuberculous pericarditis, uremic pericarditis, ventricular aneurysm, viral pericarditis
Chemical / poisoning	Asbestosis, scorpion sting
Dermatologic	Cantu syndrome, hypertrichotic osteochondrodysplasia
Drug Side Effect	Anticoagulants, chemotherapy, daunorubicin, doxorubicin, hydralazine, isoniazid, minoxidil, penicillin, phenytoin, procainamide
Ear Nose Throat	No underlying causes
Endocrine	Hypothyroidism, myxedema
Environmental	No underlying causes
Gastroenterologic	Acute pancreatitis, cirrhosis, inflammatory bowel disease
Genetic	Cantu syndrome, congenital disorders of glycosylation, hypertrichotic osteochondrodysplasia
Hematologic	Coagulopathy, leukemia, lymphoma
Iatrogenic	Cardiac catheterization, cathether ablation for arrhythmias, coronary artery bypass grafting, dialysis, heart surgery, percutaneous coronary intervention, postpericardiotomy syndrome, postpericardiotomy syndrome, radiation, TAVI, thoracic surgery, valvuloplasty
Infectious Disease	Coccidiomycosis, fungal pericarditis, histoplasmosis, infection, legionella, mycobacterium tuberculosis, neisseria, pneumococci, pyogenic pericarditis, rheumatic fever, scrub typhus, staphylococci, streptococci, syphilis, tuberculous pericarditis, viral pericarditis, pneumonia
Musculoskeletal / Ortho	Cantu syndrome, hypertrichotic osteochondrodysplasia
Neurologic	No underlying causes
Nutritional / Metabolic	Malnutrition, congenital disorders of glycosylation
Obstetric/Gynecologic	Ovarian hyperstimulation syndrome
Oncologic	Kaposi sarcoma, lymphoma, neoplasia that has spread to the pericardium, leukemia, lung cancer
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Bronchogenic cyst, lung cancer, pneumonia
Renal / Electrolyte	Nephrotic syndrome, renal failure, uremic pericarditis
Rheum / Immune / Allergy	Amyloidosis, breast cancer, collagen vascular disease, Dressler's syndrome, inflammatory bowel disease, rheumatic pericarditis, sarcoidosis, scleroderma, systemic lupus erythematosus
Sexual	No underlying causes
Trauma	Chest trauma
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Hypoalbuminemia, idiopathic, radiation

Causes in Alphabetical Order

Acute myocardial infarction Acute pancreatitis Amyloidosis Anticoagulants Aortic dissection Aortic rupture Asbestosis Bacterial pericarditis Benign obstruction of thoracic duct Breast cancer Bronchogenic cyst Cantu syndrome Capillary leak syndrome Cardiac catheterization Cardiomyopathy Chemotherapy Chest trauma Cirrhosis of liver Coagulopathy Coccidiomycosis Collagen vascular disease Congenital disorders of glycosylation Congestive heart failure Constrictive pericarditis Daunorubicin Dialysis Dilated cardiomyopathy Dissecting aortic aneurysm

Doxorubicin Dressler's syndrome Fungal pericarditis Heart surgery Histoplasmosis Hydralazine Hypersensitivity pericarditis with eosinophilia Hypertrichotic osteochondrodysplasia Hypoalbuminemia Hypothyroidism Idiopathic Infection Inflammatory bowel disease Isoniazid Kaposi sarcoma Kawasaki disease Legionella Leukemia Lung cancer Lupus Lymphoma Malnutrition Minoxidil Mycobacterium tuberculosis Myocardial rupture Myxedema Neisseria Neoplasia that has spread to the pericardium

Nephrotic syndrome Ovarian hyperstimulation syndrome Penicillin Percutaneous interventional procedures Pericarditis Phenytoin Pneumococci Pneumonia Postirradiation Postpericardiotomy syndrome Procainamide Pyogenic pericarditis Radiation Renal failure Rheumatic fever Rheumatic pericarditis Sarcoidosis Scleroderma Scorpion sting Scrub typhus Staphylococci Streptococci Syphilis Systemic lupus erythematosus Tuberculous pericarditis Uremic pericarditis Ventricular aneurysm Viral pericarditis

References

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